tibljТуберкулез и болезни легкихTuberculosis and Lung Diseases2075-12302542-1506Медицинские знания и технологии10.21292/2075-1230-2021-99-1-7-12tiblj-1497Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESПрименение разных форм тоцилизумаба в лечении пациентов со среднетяжелым и тяжелым течением COVID-19The use of different formulations of tocilizumab in the treatment of patients with moderate to severe COVID-19https://orcid.org/0000-0003-4339-126XВеселоваЕ. И.VeselovaE. I.

Веселова Елена Игоревна - научный сотрудник отдела инфекционной патологии.

127473, Москва, ул. Достоевского, д. 4, корп. 2

Elena I. Veselova - Researcher of Infectious Pathology Department.

Build. 2, 4, Dostoevskiy St., Moscow, 127473

drveselovae@mail.ruhttps://orcid.org/0000-0002-3016-6920КаминскийГ. Д.KaminskiyG. D.

Каминский Григорий Дмитриевич - руководитель отдела инфекционной патологии.

Grigoriy D. Kaminskiy - Head of Infectious Pathology Department/

Build. 2, 4, Dostoevskiy St., Moscow, 127473

gregkaminski.gk@gmail.comhttps://orcid.org/0000-0002-3091-4677ЛовачеваО. В.LovachevaO. V.

Ловачева Ольга Викторовна - доктор медицинских наук, профессор, главный научный сотрудник.

127473, Москва, ул. Достоевского, д. 4, корп. 2

Olga V. Lovacheva - Doctor of Medical Sciences, Professor, Head Researcher.

Build. 2, 4, Dostoevskiy St., Moscow, 127473

olga.lovacheva@yandex.ruhttps://orcid.org/0000-0003-1697-4670НанаеваБ. А.NanaevaB. A.

Нанаева Бэлла Александровна - заведующая отделением гастроэнтерологии.

123423, Москва, ул. Саляма Адиля, д. 2

Bella A. Nanaeva - Head of Gastroenterology Department.

2, Salyama Adilya St., Moscow, 123423

nanaeva1987@mail.ruhttps://orcid.org/0000-0002-8775-1776РомановР. И.RomanovR. I.

Романов Роман Игоревич - заведующий отделением по обеспечению взаимодействия со страховыми организациями.

123423, Москва, ул. Саляма Адиля, д. 2

Roman I. Romanov - Head of Department for Liaison with Insurance Companies.

2, Salyama Adilya St., Moscow, 123423

romigrom@yandex.ruhttps://orcid.org/0000-0003-3115-1787ВеселовА. В.VeselovА. V.

Веселов Алексей Викторович - руководитель отдела организационно-методического управления и анализа качества медицинской помощи по профилю «колопроктология».

123423, Москва, ул. Саляма Адиля, д. 2

Aleksey V. Veselov - Head of the Department for Statistics, Reporting and Analysis of Medical Care Quality in the Field of Coloproctology.

2, Salyama Adilya St., Moscow, 123423

a_veselov82@mail.ruФГБУ Национальный медицинский исследовательский центр фтизиопульмонологии и инфекционных заболеваний МЗ РФРоссияNational Medical Research Center of Phthisiopulmonology and Infectious DiseasesRussian FederationФГБУ Национальный медицинский исследовательский центр колопроктологии им. А.Н. Рыжих МЗ РФРоссияNational Medical Research Center of Coloproctology Named after A.N. RyzhikhRussian Federation202102022021991712Copyright © Веселова Е.И., Каминский Г.Д., Ловачева О.В., Нанаева Б.А., Романов Р.И., Веселов А.В., 20212021Веселова Е.И., Каминский Г.Д., Ловачева О.В., Нанаева Б.А., Романов Р.И., Веселов А.В.Veselova E.I., Kaminskiy G.D., Lovacheva O.V., Nanaeva B.A., Romanov R.I., Veselov А.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tibl-journal.com/jour/article/view/1497Цель исследования

Цель исследования: сравнение динамики С-реактивного белка (СРБ) крови на фоне введения разных лекарственных форм тоцилизумаба (ТЦЗ) у госпитализированных пациентов с COVID-19 в реальной клинической практике.

Материалы и методы

Материалы и методы. Ретроспективное исследование в когорте из 14 пациентов со среднетяжелым и тяжелым течением COVID-19, госпитализированных в стационар: 7 человек получили ТЦЗ внутривенно, 7 человек - подкожно. Критерием для назначения ТЦЗ являлось повышение в крови уровня СРБ в 5 раз и более от нормы или ферритина в 2 раза и более от нормы. В группе с подкожным введением ТЦЗ было больше у лиц старшего возраста и встречались более высокие показатели СРБ, чем в группе с внутривенным введением. Эффективность определялась по динамике СРБ на 1, 3, 7-е сут после введения. В исследование включены только пациенты, выписавшиеся из стационара с улучшением.

The objective of the study: to compare changes in the blood level of C-reactive protein (CRP) during the administration of different formulations of tocilizumab (TCZ) in COVID-19 patients admitted to hospital in real clinical practice.

Subjects and methods

Subjects and methods. The cohort of 14 patients was included in the retrospective study; they all had a severe course of COVID-19 and were admitted to hospital: 7 patients received had intravenous infusions of tocilizumab and 7 had subcutaneous injections. The indication for tocilizumab prescription was the elevation of CRP blood level by 5 times and more or 2-fold and more elevation of ferritin above the norm. In the group receiving subcutaneous injections with tocilizumab, the proportion of elderly people was bigger and CRP levels were higher versus the group receiving intravenous infusions. The efficacy was assessed by changes in CRP levels on the 1st, 3rd and 7th day after the administration. The study included only the patients discharged from hospital with improvement of their state.

Results

Results. It has been demonstrated that when the patients develop cytokine storm, the use of both formulations of tocilizumab (for intravenous and subcutaneous administration) is effective. When tocilizumab was administered intravenously, the changes in CRP levels (especially at high rates - more than 150 mg/l) were more intense versus subcutaneous administration. The use of these formulations of tocilizumab had the same long-term efficacy: the level of CRP by the 7th day after administration decreased comparably in both groups, the time of complete normalization of this rate did not differ significantly. The different dynamics of CRP level decrease in each specific case could be associated both with the formulation of the drug and other factors that could not be established.

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The authors declare that there are no conflicts of interest present.